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S Schonfeld

Publications and source records attributed to S Schonfeld.

At least 19 recordsLinked to original sources
PubMed2001

Contrast-enhanced carotid MR angiography with commercially available triggering mechanisms and elliptic centric phase encoding.

OBJECTIVE: The technical feasibility of contrast-enhanced MR angiography of the carotid arteries was evaluated with routinely available timing sequences and elliptic centric acquisition. The image quality of the contrast-enhanced MR angiography was compared with that of multiple overlapping thin-section acquisition MR angiography (MOTSA MR angiography). SUBJECTS AND METHODS: Sixty-three patients were enrolled. A 2-mL test bolus and commercially available software were used to time the gadolinium bolus. High-resolution contrast-enhanced MR angiography was performed with elliptic centric acquisition. RESULTS: The average time of bolus arrival was 17.3 sec (range, 12-25 sec). In 60 of the 63 patients, we had excellent or good visualization of the carotid bifurcation using contrast-enhanced MR angiography with little or no venous contamination. Two observers ranked delineation of stenosis and morphology of proximal internal carotid artery and overall diagnostic confidence statistically significantly higher for contrast-enhanced MR angiography compared with MOTSA: Ulceration, length of stenosis, and slow flow distal to a critical stenosis were better depicted with contrast-enhanced MR angiography than with MOTSA: Venetian blind artifact, saturation of slow or in-plane flow, and artifactual narrowing in carotid artery kinks plagued MOTSA but were not seen on contrast-enhanced MR angiography. MOTSA was graded superior to contrast-enhanced MR angiography in nine of 120 carotid bifurcations analyzed. CONCLUSION: High-resolution carotid contrast-enhanced MR angiography is technically feasible. We found a 95% success rate using commercially available hardware and software. The image quality with carotid contrast-enhanced MR angiography has improved so that it is equal or superior to the longer MOTSA in most patients.

Adult↗
PubMed1999

White matter disorders of prematurity: association with intraventricular hemorrhage and ventriculomegaly. The Developmental Epidemiology Network.

OBJECTIVES: Because intraventricular hemorrhage (IVH) often precedes the development of sonographically defined white matter damage (WMD) in very preterm infants, we sought to identify the IVH characteristics that predict WMD. HYPOTHESES: We evaluated variations on the null hypothesis that infants with IVH are no more likely than infants without IVH to have WMD. These variations dealt with characteristics of the IVH (presence or absence of ventriculomegaly) or characteristics of the WMD (size, localization, and laterality). METHODS: A total of 1605 infants weighing 500 to 1500 g at birth between January 1991 and December 1993 underwent standardized cranial ultrasound studies with 6 standard coronal and 5 sagittal views at postnatal days 1 to 3, 7 to 10, and at 3 to 8 weeks. RESULTS: A total of 129 (8%) infants had WMD, either an echodensity alone (n = 59), an echolucency alone (n = 18), or both (n = 52). In analyses that controlled for gestational age, IVH was associated with a fivefold to ninefold increased risk of WMD regardless of size, laterality, or extent of lesions (P </=.0005). Compared with infants with neither IVH nor ventriculomegaly, infants with both were at 18- to 29-fold greater risk of WMD (P </=.0005). CONCLUSIONS: In this study IVH and ventriculomegaly were powerful predictors of WMD occurrence, whether small or large, unilateral or bilateral, localized or diffuse.

Brain Diseases↗
PubMed1999

Maternal infection, fetal inflammatory response, and brain damage in very low birth weight infants. Developmental Epidemiology Network Investigators.

Echolucent images (EL) of cerebral white matter, seen on cranial ultrasonographic scans of very low birth weight newborns, predict motor and cognitive limitations. We tested the hypothesis that markers of maternal and feto-placental infection were associated with risks of both early (diagnosed at a median age of 7 d) and late (median age = 21 d) EL in a multi-center cohort of 1078 infants <1500 x g. Maternal infection was indicated by fever, leukocytosis, and receipt of antibiotic; fetoplacental inflammation was indicated by the presence of fetal vasculitis (i.e. of the placental chorionic plate or the umbilical cord). The effect of membrane inflammation was also assessed. All analyses were performed separately in infants born within 1 h of membrane rupture (n = 537), or after a longer interval (n = 541), to determine whether infection markers have different effects in infants who are unlikely to have experienced ascending amniotic sac infection as a consequence of membrane rupture. Placental membrane inflammation by itself was not associated with risk of EL at any time. The risks of both early and late EL were substantially increased in infants with fetal vasculitis, but the association with early EL was found only in infants born > or =1 after membrane rupture and who had membrane inflammation (adjusted OR not calculable), whereas the association of fetal vasculitis with late EL was seen only in infants born <1 h after membrane rupture (OR = 10.8; p = 0.05). Maternal receipt of antibiotic in the 24 h just before delivery was associated with late EL only if delivery occurred <1 h after membrane rupture (OR = 6.9; p = 0.01). Indicators of maternal infection and of a fetal inflammatory response are strongly and independently associated with EL, particularly late EL.

Brain Damage, Chronic↗
PubMed1996

Can noninvasive studies replace conventional angiography in the preoperative evaluation of carotid stenosis?

Most articles in 1995 demonstrated a sensitivity of 100% and specificities of 90% to 98% in detecting carotid bifurcation stenosis using a combination of MR angiography and ultrasonography, reserving conventional angiography for cases of disparate stenosis with the noninvasive studies. Multiple reviews concluded that noninvasive studies were less morbid than conventional angiography when taking into account the risks of conventional angiography and surgery as well as the morbidity associated with unnecessary surgery (false-positive noninvasive study) or withholding indicated surgery (false-negative noninvasive study). Thus, the current literature suggests that non-invasive studies have indeed reached a point where they can replace conventional angiography in the preoperative evaluation of carotid bifurcation stenosis. It is paramount that each imaging center review its own sensitivity and specificity in detecting surgically significant carotid stenosis with noninvasive studies. High sensitivity and specificity in diagnosing percent carotid stenosis with noninvasive studies can occur today with routine imaging equipment, but it takes a great deal of effort and dedication on the part of the imaging center.

Angiography↗
PubMed1995

Radiology on the information superhighway.

PURPOSE: To explore the potential for the information superhighway to provide radiologists with new opportunities. MATERIALS AND METHODS: The Internet was used as the communication and distribution medium. MOSAIC, a graphical interface, provided access for clients, and a computer was used to serve text, images, sound, and cine onto the Internet. RESULTS: The system can be used to send reports and images to referring physicians or consulting radiologists; to provide a large database that is constantly available; to provide an increasing collection of teaching files; and to distribute interactive, multimedia teaching tools that can be used on any computer system. The use of the MOSAIC interface facilitates interaction, which allows users with limited computer experience to access the system. CONCLUSION: The Internet can dramatically expand the ways radiologists interact with their colleagues. These preliminary results indicate that there will be great challenges and opportunities for improving care and teaching in the future.

Computer Communication Networks↗
PubMed1994

Post pulmonary embolism pericarditis. A rare entity diagnosed by combined lung scanning and chest radiograph study.

A patient is described in whom pericarditis appeared a few days after pulmonary embolism. Prompt improvement was noted following corticosteroid therapy. The possibility of pericarditis appearing following pulmonary embolism should be kept in mind, considering that both entities present with similar clinical manifestations but require different therapeutic approaches. The combination of ventilation and perfusion lung scanning and plain chest radiographs for the prompt and early diagnosis of post pulmonary embolism pericarditis, is illustrated.

Diagnosis, Differential↗
PubMed1993

Digital subtraction angiography--a new approach to brain death determination in the newborn.

The diagnosis of brain death in the newborn infants is elusive and often difficult. The lack of cerebral blood flow has become an identified criterion for loss of cerebral function. The diagnosis can be obtained by the technique of digital subtraction angiography, which is presented in two case reports demonstrating the utility of this technique.

Angiography, Digital Subtraction↗
PubMed1992

The central New Jersey neonatal brain haemorrhage study: design of the study and reliability of ultrasound diagnosis.

Over a 34-month period, 1105 newborns weighing between 501 and 2000 g at birth were enrolled in a prospective study of the aetiology and consequences of neonatal brain haemorrhage. The three participating hospitals care for approximately 85% of births in the study weight range in Middlesex, Monmouth and Ocean counties, New Jersey. Cranial ultrasonographic imaging through the anterior fontanelle was carried out a mean age of 4.9 +/- 2.2 hours, 25.5 +/- 4.8 hours and 7.2 +/- 0.8 days to detect haemorrhage and other brain lesions. In 93.2% of study infants, scans were read by two independent expert readers (blind to the clinical status of the child) with submission of the scan to a third reader in cases of disagreement. Confirmation of both presence or absence and, when present, scan of first diagnosis of germinal matrix and/or intraventricular haemorrhage (GM/IVH) by two independent readers was achieved in 76.3% of study infants. The first two readers agreed as to presence or absence of GM/IVH in 82.4% of infants (Kappa = 0.56). Interobserver agreement was affected by the reported scan quality and by the number of scans available, but not by the hospital of origin, race or birthweight of the infant.

Birth Weight↗
PubMed1990

[Malabsorption in systemic lupus erythematosus].

A 25-year-old man, who was admitted for evaluation of arthralgia and fever of 2-weeks duration, complained of a 10 kg weight loss during the previous weeks. Systemic lupus erythematosus (SLE) was diagnosed on the basis of leukopenia, LE cells, antinuclear antibodies, antibodies to double-stranded DNA, and arthritis, Malabsorption was diagnosed because of the finding of hypoalbuminemia, fat droplets in the feces, a pathological D-xylose test, and an appropriate X-ray image. Approximately half the patients with SLE develop minor expressions of gastrointestinal tract involvement, such as nausea, vomiting, and diarrhea. Major manifestations, such as intestinal obstruction or perforation, ascites, peritonitis and pancreatitis have been reported with varying frequency. Despite the frequent association of SLE with gastrointestinal manifestations, malabsorption, as in this case, has rarely been reported.

Adult↗
PubMed1990

[Pseudomonas aeruginosa arthritis and discitis in systemic lupus erythematosus].

Patients with systemic lupus erythematosus (SLE) are prone to develop opportunistic infections. Nevertheless, arthritis due to Pseudomonas aeruginosa in SLE is very rare and seems to be related to corticosteroid therapy and previous penetrating injury. A 17-year-old girl with SLE and Pseudomonas arthritis and discitis which followed laparotomy is described. Arthritis is a common manifestation of SLE, but arthritis due to infection with Pseudomonas is very serious and the diagnosis should not be missed.

Adolescent↗
PubMed1989

[Chronic subdural hematoma simulating transient ischemic attacks].

Chronic subdural hematoma presenting as transient ischemic attacks (TIA) is very rare. In a 74-year-old man in whom chronic subdural hematoma was responsible for recurrent attacks of local neurological deficiencies, the diagnosis was established by computerized tomographic (CT) scanning. Both TIA and chronic subdural hematoma usually occur in the elderly. Since the prognosis as well as the therapeutic approach are completely different in the 2 conditions, it is advisable to use imaging techniques, such as CT scanning, when there are recurrent TIA.

Aged↗
PubMed1988

Interobserver variability in neonatal cranial ultrasonography.

The reliability of cranial ultrasound diagnosis in the premature neonate was examined using data from an ongoing multicentre study of the epidemiology and long-term consequences of neonatal brain haemorrhage. First week ultrasound films (obtained at 4 hours, 24 hours and 7 days) from 60 study subjects were randomly selected for independent review by two groups of experienced interpreters, and results were recorded separately for observations (i.e. presence or absence of an abnormal echodense area on a film) and interpretations (i.e. presence or absence of haemorrhage or ventricular dilatation) in each hemisphere. Because of deaths in the first week of life, the total number of films examined was 138. Concordance on the presence or absence of an abnormal echodensity was examined for each individual film for three areas of interest: the germinal matrix, the ventricles and the parenchyma. Concordance on the presence or absence of haemorrhage or ventricular dilatation was examined only for the seventh-day film, or the final film prior to death. Finally, concordance was analysed with the diagnostic interpretations grouped into categories thought to differ prognostically for long-term outcome. In general, concordance was poorest for germinal matrix lesions and best for parenchymal lesions. Concordance was lower for observations made on each individual film than it was for interpretation of the final film in each case. Fifty-five of 60 cases (92%) were assigned to the same major prognostic category by both readers. Ultrasound review conferences were held periodically and there was evidence that concordance in ultrasound reading and interpretation improved during the course of the study.

Cerebral Hemorrhage↗
PubMed1988

[Angioimmunologic lymphadenopathy evolving into malignant lymphoma and associated with Kaposi's sarcoma].

Angioimmunoblastic lymphadenopathy with dysproteinemia is a recently described entity with severe clinical symptoms and characteristic histological findings in the lymph nodes with occasional malignant transformation. Kaposi's sarcoma is a neoplastic angiomatous growth of unknown origin. Alterations in the immune system have been reported in both diseases. The association of angioimmunoblastic lymphadenopathy with dysproteinemia and Kaposi's sarcoma in the same patient may suggest a common origin for both.

Bone Marrow↗